MEDICARE: DANIEL WILLIAM CABLE PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22057	OTHER	CA	PHYSICIAN ASSISTANT BOARD

General Provider Information

NPI Number	:	1124355441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL WILLIAM CABLE PA-C

Provider Business Mailing Address
First Line	:	536 CAMINO MERCADO
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-1814
Country	:	US
Telephone Number	:	805-540-0279
Fax Number	:	800-417-9245

Provider Business Practice Location Address
First Line	:	536 CAMINO MERCADO STE 536
Second Line	:
City	:	ARROYO GRANDE
State	:	CA
Zip	:	93420-1814
Country	:	US
Telephone Number	:	805-540-0279
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2009
Last Update Date	:	04/24/2026

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